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  #1  
Old 23-05-13, 10:18
Triguy Triguy is offline
 
Join Date: May 2013
Posts: 5
Any advice when reducing Dose from 40mg

New to forum as a registered user although I have been using it as a help for many years.

I had a epidoe in March 2013 aftre using citalpram Successfully for 2 years. Doctor increased dosage to 30mg but stupidly afgtre no improvement i increased to 40mg. Last week I realised I feel like a robot (i think others have used this analogy) at work and at home. Its almost like I'm watching myself play out my live and my performance at work is suffering badly.

Should I come down to 20mg straight away or 30mg and what period of time. Couldn't get a call back with my doctor till Friday so just wanted a heads up from those that have been in situation.

Thanks in Advance All.
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  #2  
Old 23-05-13, 13:33
keithwms keithwms is offline
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Re: Any advice when reducing Dose from 40mg

Hi, welcome, and sorry to hear of your travails... they are familiar!

First the usual disclaimer, there is no single solution for everybody. We all seem to react a little differently.

I haven't reduced dose on citalopram yet... I was on other meds now and am now trying citalopram. I just went from 10 to 20 and am slowly getting back to more balanced moods. This stuff brings on all manner of anxiety when there's a dose change! This appears to be true for any dose changes, up or down.

From my readings, it seems that the minimal time to stabilize at one dose is typically ~2 weeks. By 'stabilize' I mean, get past the primary side effects and so forth. This being the case, it seems likely that you should stay at your current dose through two weeks, then taper down to the next lower dose and stay there for two weeks, etc.

Of course, the correct way to do this is in regular consultation with your doc and therapist, and with a support group in place- family, friends, who I hope can provide encouragement and points of reference regarding your mood changes.

I hope it goes smoothly for you! I think it will, but it does take patience to sort the doses.
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"Tous les jours à tous points de vue je vais de mieux en mieux" (Every day, in every way, I am getting better and better) - Émile Coué

"If you are going through hell, keep going." - Winston Churchill

"When it is dark enough, you can see the stars." - Ralph Waldo Emerson
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  #3  
Old 24-05-13, 15:11
Triguy Triguy is offline
 
Join Date: May 2013
Posts: 5
Re: Any advice when reducing Dose from 40mg

hi, thanks for reply again usual disclaimers to anyone else reading this. But the doctor suggested coming off them by 10mg per week so this week cut down to 30mg, then the following week 20mg and then 10mg? This seemed fairly radical given what I know when i went up and from discussing it with a friend she suggested, 2 weeks is the period of reduction. reduce to 30mg for 2 weeks then back to 20mg for 2 weeks. or trying 40mg/30mg alternate days for 1 week, then 30mg/20mg. Seems a better plan.

Cheers and good fortune everyone Hopefully i will get feeling back, less like a robot, might mean a few lows but hopefully I might get out of Neutral into 1st gear a couple of times.
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  #4  
Old 24-05-13, 15:56
keithwms keithwms is offline
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Re: Any advice when reducing Dose from 40mg

10mg per weeks seems a bit too fats for me, I would be tempted to do 10mg / two weeks. But it's all very individual of course. And there is something to be said for getting it over with quickly

One issue to consider with these meds when going up or down in dose is 'half life.' During treatment, you usually want a longer half life so that the chemical swings are more rectified and you don't have a big issue if you miss a dose or if your timing is off a bit. But when coming down in dose, a longer half life could mean that withdrawal symptoms persist longer, as it takes longer for the body to clear the med and find the new equilibrium. Of course, this is a separate issue than how acute the side-effects are- I am just talking about how long they persist, because I find that as long as we have reasonable expectations then at least we have something to look forward too and can soldier through with confidence. Citalopram seems to give pretty variable results, with some people feeling the effects from an up/down dose change almost instantly, while others take weeks. Worst case seems to be around two months to stabilize at a new dose. So my question to you is... why rush?

I know this is not terribly reassuring but the point is that it's individual and you have to try and see for yourself... and keep your communications with your doc, therapist, and support crew open throughout. The reassuring bit is that many have gone through this successfully and you can too!
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"Tous les jours à tous points de vue je vais de mieux en mieux" (Every day, in every way, I am getting better and better) - Émile Coué

"If you are going through hell, keep going." - Winston Churchill

"When it is dark enough, you can see the stars." - Ralph Waldo Emerson
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  #5  
Old 31-05-13, 09:59
Triguy Triguy is offline
 
Join Date: May 2013
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Re: Any advice when reducing Dose from 40mg

Update in case this might be useful to others. So I did initally go down to 20mg for 5 days but aftre posting just over a week ago i starting taking 20mg/30mg on alternate days and this is fine and i will contiune this approach until I'm ready to maybe go to 20mg my Orignal dose for the last 2years. (good news Feel back in the room', sex drive back and things are going well)
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